Neighborhood Health Plan of Rhode Island (NHPRI) offers a dedicated Provider Portal designed to streamline communication and access for healthcare professionals across various service lines. This secure digital platform enables providers to efficiently manage patient information, claims, and critical healthcare resources.
Official Links
- Provider Portal Page: https://www.nhpri.org/providers/
- Provider Portal Access Application: https://www.nhpri.org/provider-portal-access-application/
What Providers Can Do
The Provider Portal serves as a comprehensive digital resource for healthcare professionals, offering:
- Access to claims and eligibility information
- Behavioral health service management
- Network updates and communications
- Provider training resources
- Policy and guideline references
Who Can Use the Portal
The portal is specifically designed for:
- Individual healthcare providers
- Medical group practices
- Institutional healthcare providers affiliated with Neighborhood Health Plan of Rhode Island
Access and Registration
Registration Process
Providers must complete an official application that constitutes an agreement between the provider and Neighborhood Health Plan of Rhode Island. The registration process involves:
- Completing the online application
- Maintaining current Rhode Island Medicaid screening
- Ensuring NPI (National Provider Identifier) screening status remains current
Key Features and Services
Provider Training Requirement
- Annual training is mandatory for network providers
- Training provides an overview of Neighborhood’s plans, policies, and procedures
- Providers can complete training directly through the portal
Behavioral Health Management
- Effective September 1, 2025, NHPRI will directly manage behavioral health services
- Providers will have direct access to updated behavioral health service information
Privacy and Security
Compliance Commitments
- Adheres to civil rights laws
- Non-discriminatory access
- Provides language assistance
- Follows strict privacy and security protocols
Important Reminders for Providers
- Complete and maintain Rhode Island Medicaid screening
- Ensure NPI screening status does not expire
- Participate in annual provider training
- Stay updated through quarterly provider newsletters
Provider Support Resources
Communication Channels
- Provider Newsletter
- Email update registration
- Member Services Call Center
Upcoming Changes and Notifications
Key Updates
- Closure of Anchor Medical Associates (June 30, 2025)
- Behavioral health services management transition (September 1, 2025)
Unprovided Information
Some specific details were not available in the source documents, such as:
- Exact login procedures
- Detailed step-by-step portal navigation
- Specific technical requirements for portal access
The Neighborhood Health Plan of Rhode Island Provider Portal represents a critical digital tool for healthcare professionals, offering secure, efficient access to essential resources and streamlining provider-insurer communication.
Note to Providers: Always refer to the official NHPRI website for the most current information and portal access guidelines.
FAQ
What kind of insurance is a neighborhood health plan?A neighborhood health plan typically offers a few kinds of coverage. You can find commercial plans, which are for individuals who buy their own insurance or for people who get coverage through a small employer. They also often have specific Medicaid plans for those who meet certain eligibility rules.
Is the neighborhood health plan of RI Medicaid?
What is the neighborhood health plan in Massachusetts?
Who owns the neighborhood health plan of Rhode Island?Rhode Island Foundation completes acquisition of Neighborhood Health Plan of Rhode Island. PROVIDENCE — The Neigborhood Health Plan of Rhode Island (NHPRI) has ended its Boston-based ownership.
https://www.nhpri.org/providers/
Neighborhood Health Plan of Rhode Island network providers are required to complete an annual training. The provider training offers an overview of
https://www.nhpri.org/provider-portal-access-application/
This application constitutes an agreement between Neighborhood Health Plan of RI (Neighborhood) and its affiliated professional or institutional provider.